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BreastfeedingPREPARENCT04258709

PRenatal Video-Based Education and PostPARtum Effects

A study testing AME and Video-based infant care education in people with Breastfeeding, run by University of Pittsburgh at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this randomized controlled trial is to examine the impact of a remotely-delivered antenatal milk expression (AME) intervention versus an attention control condition on breastfeeding outcomes among a sample of 280 nulliparous, non-diabetic women with pre-pregnancy body mass indices ≥ 25. Read more about this study

Who is it for?
Ages 18 to 45 years, women onlyHealthy volunteers can take part
Conditions the study is for
Breastfeeding
What is being tested?
AME and Video-based infant care education
Could I receive a placebo?
No, everyone receives an active treatment
How many people
280 participants
Where
1 siteUnited States
Study dates
23 Sep 2020to 29 Nov 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Pregnant women who:
  • have a pre-pregnancy BMI ≥ 25
  • are ≥ 18 years
  • are English-speaking
  • are 34 0/7-36 6/7 gestational weeks
  • are nulliparous
Show all 9Show fewer
  • intend to/have interest in breastfeeding after birth
  • are having a singleton pregnancy
  • plan to receive prenatal care and deliver at select hospital/birth facility systems (access to EMR data)

Who cannot join

  • contraindications to breastfeeding as specified by the American Academy of Pediatrics
  • history of breast reduction surgery or radiation
  • indication for delivery by 37 weeks gestation
  • gestational or pre-existing diabetes

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Pittsburgh

    Pittsburgh, Pennsylvania, 15213

Other trials in United States

About this study

Official title: Effect of Antenatal Milk Expression on Breastfeeding Outcomes Among Overweight and Obese Women

The purpose of this randomized controlled trial is to examine the impact of a remotely-delivered antenatal milk expression (AME) intervention versus an attention control condition on breastfeeding outcomes among a sample of 280 nulliparous, non-diabetic women with pre-pregnancy body mass indices ≥ 25. AME involves milk expression and collection in the third pregnancy trimester and is theorized to address multiple barriers to breastfeeding among women with higher BMI, including impaired breastfeeding self-efficacy, insufficient milk supply (critical period endocrine modulation of milk volume), and early formula supplementation in the context of a medically complex birth (availability of banked antenatal milk).

Participants will be enrolled in their third trimester of pregnancy and allocated into one of two study arms: 1) AME instruction delivered by remote, live International Board Certified Lactation Consultants via an innovative app-based telelactation platform; or 2) an attention control condition (video-based infant care education unrelated to infant feeding). Video-based education for both groups will occur in weekly study visits from 37 to 40 weeks gestation, with women in the intervention group continuing AME 1-2 times per day at home.

Measured outcomes of interest will include short and long-term breastfeeding practices (e.g., breastfeeding duration, exclusivity) and participants' experiences with and perceptions of AME.

Read the detailed description

The purpose of the PREPARE Trial is to examine the impact of an antenatal milk expression (AME) intervention among women with pre-pregnancy BMI 25 or more on breastfeeding outcomes, including breastfeeding self-efficacy, breastfeeding duration and exclusivity, and perception of insufficient milk supply. Specifically, the investigators will:

  1. Determine the effect of the AME intervention on short-term breastfeeding outcomes, including breastfeeding self-efficacy and exclusivity, to two weeks postpartum.
  2. Explore the sustained effect of the AME intervention on longer-term breastfeeding duration and exclusivity over the first year postpartum.
  3. Examine participants' experiences with and perceptions of AME.
Conditions
Breastfeeding
Being tested
AME, Video-based infant care education
Keywords
antenatal milk expression, antenatal colostrum
Medical subject headings
Breast Feeding

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AMEBehavioural

    Participants receive education on AME and feedback on technique with a remotely-based IBCLC via live streaming video.

  • Video-based infant care educationBehavioural

    Participants view a standard set of web-based streamed videos addressing evidence-based infant care, unrelated to feeding/breastfeeding.

Study groups in NCT04258709
Study groupRoleWhat they receive
Antenatal Milk Expression (AME) Intervention GroupExperimentalWeekly video interactions (weeks 37-40 of pregnancy) with International Board Certified Lactation Consultants (IBCLCs) to teach and reinforce antenatal milk expression. At-home practice of hand expression and collection of any expressed milk.
Receives: Behavioral: AME
Video-based Infant Care Education Control GroupActive comparatorWeekly video education (weeks 37-40 of pregnancy) on various topics related to infant care (e.g., safe sleep, car seat safety, etc.).
Receives: Behavioral: Video-based infant care education

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Breastfeeding Exclusivity

    Whether participant is feeding 100% breast milk at 2 weeks postpartum

    Measured: 2 weeks postpartum

  2. Breastfeeding Self-efficacy

    Score on Breastfeeding Self-Efficacy Scale-SF (score range 14-70, with higher score represents better outcome)

    Measured: 2 weeks postpartum

Secondary outcomes (26)
  1. Number of Participants Exclusively Breastfeeding During Postpartum Hospitalization

    This variable was derived from the infant's feeding documentation via Electronic Medical Record. Responses for Breastfeeding Exclusivity were categorized as YES if the infant had been fed only their mother's own breast milk. Responses were categorized as NO if they had received anything other than only their mother's own breast milk (e.g., formula + their own milk, formula only).

    Measured: Postpartum hospitalization (0-4 days postpartum)

  2. Number of Participants Exclusively Breastfeeding at 2 Weeks Postpartum

    This variable derived from participant self-report survey emailed at 2 weeks postpartum. Responses for Breastfeeding Exclusivity were categorized as YES if the infant had been fed only their mother's own breast milk. Responses were categorized as NO if they had received anything other than only their mother's own breast milk (e.g., formula + their own milk, formula only).

    Measured: 2 weeks postpartum

  3. Number of Participants Exclusively Breastfeeding at 6 Weeks Postpartum

    This variable derived from participant self-report survey emailed at 6 weeks postpartum. Responses for Breastfeeding Exclusivity were categorized as YES if the infant had been fed only their mother's own breast milk. Responses were categorized as NO if they had received anything other than only their mother's own breast milk (e.g., formula + their own milk, formula only).

    Measured: 6 weeks postpartum

  4. Number of Participants Exclusively Breastfeeding at 12 Weeks Postpartum

    This variable derived from participant self-report survey emailed at 12 weeks postpartum. Responses for Breastfeeding Exclusivity were categorized as YES if the infant had been fed only their mother's own breast milk. Responses were categorized as NO if they had received anything other than only their mother's own breast milk (e.g., formula + their own milk, formula only).

    Measured: 12 weeks postpartum

  5. Number of Participants Exclusively Breastfeeding at 6 Months Postpartum

    This variable derived from participant self-report survey emailed at 6 months postpartum. Responses for Breastfeeding Exclusivity were categorized as YES if the infant had been fed only their mother's own breast milk. Responses were categorized as NO if they had received anything other than only their mother's own breast milk (e.g., formula + their own milk, formula only).

    Measured: 6 months postpartum

  6. Breastfeeding Exclusivity (Categorical)

    Categorical outcome indicating proportional range of breast milk feeds during postpartum/birth hospitalization (0-4 days postpartum)

    Measured: 0-4 days postpartum

  7. Breastfeeding Exclusivity (Categorical)

    Categorical outcome indicating proportional range of breast milk feeds since infant was born

    Measured: 2 weeks

  8. Breastfeeding Exclusivity (Categorical)

    Categorical outcome indicating proportional range of breast milk feeds in past week

    Measured: 6 weeks postpartum

  9. Breastfeeding Exclusivity (Categorical)

    Categorical outcome indicating proportional range of breast milk feeds in past week

    Measured: 12 weeks postpartum

  10. Breastfeeding Exclusivity (Categorical)

    Categorical outcome indicating proportional range of breast milk feeds in past week

    Measured: 6 months postpartum

  11. Breastfeeding Self-efficacy

    Scores on Breastfeeding Self-Efficacy Scale-SF(score range 14-70, with higher score represents better outcome)

    Measured: 6 weeks postpartrum

  12. Breastfeeding Self-efficacy

    Scores on Breastfeeding Self-Efficacy Scale-SF(score range 14-70, with higher score represents better outcome)

    Measured: 12 weeks postpartum

  13. Number of Participants Breastfeeding at Postpartum Hospitalization (0-4 Days Postpartum)

    This variable was derived from the infant's feeding documentation via Electronic Medical Record. Responses were categorized as YES for Breastfeeding Duration if they answered that they were still feeding their own breast milk to their infant at each respective timepoint. Please note that responses were still classified as a YES if they were combination feeding (e.g., using their own breast milk along with formula, solids, etc.). Responses were categorized as NO if they had ceased to provide any of their own breast milk to their infant.

    Measured: Postpartum hospitalization (0-4 days postpartum)

  14. Number of Participants Breastfeeding at 2 Weeks Postpartum

    Participants were asked what their infant was currently being fed. Responses were categorized as YES for Breastfeeding Duration if they answered that they were still feeding their own breast milk to their infant at each respective timepoint. Please note that responses were still classified as a YES if they were combination feeding (e.g., using their own breast milk along with formula, solids, etc.). Responses were categorized as NO if they had ceased to provide any of their own breast milk to their infant.

    Measured: 2 weeks postpartum

  15. Number of Participants Breastfeeding at 6 Weeks Postpartum

    Participants were asked what their infant was currently being fed. Responses were categorized as YES for Breastfeeding Duration if they answered that they were still feeding their own breast milk to their infant at each respective timepoint. Please note that responses were still classified as a YES if they were combination feeding (e.g., using their own breast milk along with formula, solids, etc.). Responses were categorized as NO if they had ceased to provide any of their own breast milk to their infant.

    Measured: 6 weeks postpartum

  16. Number of Participants Breastfeeding at 12 Weeks Postpartum

    Participants were asked what their infant was currently being fed. Responses were categorized as YES for Breastfeeding Duration if they answered that they were still feeding their own breast milk to their infant at each respective timepoint. Please note that responses were still classified as a YES if they were combination feeding (e.g., using their own breast milk along with formula, solids, etc.). Responses were categorized as NO if they had ceased to provide any of their own breast milk to their infant.

    Measured: 12 weeks postpartum

  17. Number of Participants Breastfeeding at 6 Months Postpartum

    Participants were asked what their infant was currently being fed. Responses were categorized as YES for Breastfeeding Duration if they answered that they were still feeding their own breast milk to their infant at each respective timepoint. Please note that responses were still classified as a YES if they were combination feeding (e.g., using their own breast milk along with formula, solids, etc.). Responses were categorized as NO if they had ceased to provide any of their own breast milk to their infant.

    Measured: 6 months postpartum

  18. Number of Participants Breastfeeding at 12 Months Postpartum

    Participants were asked what their infant was currently being fed. Responses were categorized as YES for Breastfeeding Duration if they answered that they were still feeding their own breast milk to their infant at each respective timepoint. Please note that responses were still classified as a YES if they were combination feeding (e.g., using their own breast milk along with formula, solids, etc.). Responses were categorized as NO if they had ceased to provide any of their own breast milk to their infant.

    Measured: 12 months postpartum

  19. Onset of Lactogenesis II

    Recall of lactogenesis II in post-birth days

    Measured: 2 weeks postpartum

  20. Perceived Milk Supply (Continuous)

    Score on PIBBS subscale of H \& H Lactation Scale measuring perceived infant satisfaction with breast milk received (score range: 5-35, higher score is better outcome)

    Measured: 2 weeks postpartum

  21. Perceived Milk Supply (Continuous)

    Score on PIBBS subscale of H \& H Lactation Scale measuring perceived infant satisfaction with breast milk received (score range: 5-35, higher score is better outcome)

    Measured: 6 weeks postpartum

  22. Perceived Milk Supply (Continuous)

    Score on PIBBS subscale of H \& H Lactation Scale measuring perceived infant satisfaction with breast milk received (score range: 5-35, higher score is better outcome)

    Measured: 12 weeks postpartum

  23. Perceived Milk Supply (Dichotomous)

    Endorsement of insufficient milk supply via investigator created item (dichotomous outcome)

    Measured: 2 weeks postpartum

  24. Perceived Milk Supply (Dichotomous)

    Endorsement of insufficient milk supply via investigator created item (dichotomous outcome)

    Measured: 6 weeks postpartum

  25. Perceived Milk Supply (Dichotomous)

    Endorsement of insufficient milk supply via investigator created item (dichotomous outcome)

    Measured: 12 weeks postpartum

  26. Number of Participants Commenting on the Impact/Integration of AME During Pregnancy and Utilization of Antenatally Collected Milk During the Postpartum Period

    A subset of participants took place in a qualitative assessment via semi-structured interview. Numbers below represent the number of participants who endorsed each of the following categories during their interview: 1) discussing the impact of the study on their pregnancy/postpartum experience, 2) integration of AME into their daily life, and 3) utilization of antenatal milk during the postpartum period

    Measured: 6 weeks postpartum

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Feb 2020
  2. Study start23 Sep 2020
  3. Primary completion13 Dec 2023
  4. Study completion29 Nov 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
280 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04258709
Sponsor's protocol ID
STUDY19030116
Other IDs
R01HD098186
Acronym
PREPARE
Status last verified
Feb 2025
First submitted
3 Feb 2020
Last updated
19 Mar 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Raw (subject level) and/or aggregate data will be shared with other investigators as requested after: 1) publication of main findings; 2) removal of identifiers that would permit linkages to individual research participants; and 3) removal of variables that could lead to deductive disclosure of the identity of individuals. Any individual requests for data sharing will be executed in collaboration with the University of Pittsburgh Institutional Review Board to ensure strict adherence to policies for protections of human subjects. In addition, at the conclusion of the study, de-identified data will be submitted to the National Institute of Child Health and Development (NICHD) Data Repository to ensure public availability.

Publications

  • Demirci JR, Glasser M, Bogen DL, Sereika SM, Ren D, Ray K, Bodnar LM, O'Sullivan TA, Himes K. Effect of antenatal milk expression education on lactation outcomes in birthing people with pre-pregnancy body mass index >/=25: protocol for a randomized, controlled trial. Int Breastfeed J. 2023 Mar 16;18(1):16. doi: 10.1186/s13006-023-00552-6.

    PubMed 36927811

Questions about this trial

What is this clinical trial studying?

A study testing AME and Video-based infant care education in people with Breastfeeding, run by University of Pittsburgh at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Mar 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Breastfeeding Exclusivity (time frame: 2 weeks postpartum). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04258709, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Mar 2025.

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